Ricketts, Frank NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
This Permit can be signed only by the Local Registrar (Deputy or Subregistrar) of the Primary Registration District (Town,
Village, or City) in which the death occurred after the FILING and acceptance of a CORRECT AND COMPLETE CERTIFICATE OF
DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK.
Dist. No. 5601 Registered No. 83
;7arren Town 78 Park St . Glens Falls, N. Y.
County Village
or City (If city, give street address)
Name of deceased Frank Ricketts
Male White Single, married, widowed, vri d owe d
Sex Color or divorced (write the word) Date of Death Larch, 1,6, 19 37
Age 83 Years 5 Months 5 Days Birthplace.......Qn....hi.gh....Seas.
Cause of Death Arterio—sclerosis
Certificate was signed by Dr. George A. Chapman M.D.
Address Glens Falls, N. Y.
Place of Burial (or Removal) Town of Q.ueensb.Lbryy Warren—Co,
(If body is to be temporarily held, fill in space later)
Cemetery Pine View Qe nt e.tt.. .ry Date of Burial aka rCh 1.8., 19...37..
(If body is to be temporarily held, fill in space later)
The Certificate of Death containing the above stated particulars, having been presented to me, after careful examina-
tion, the same appearing to be COMPLETE, CORRECT, AND SATISFACTORY AS REQUIRED BY LAW,
I have accepted the same for registration, have recorded it in my Local Record with the above stated Registered Number,
and on the basis thereof I HEREBY GRANT A PERMIT
to Harold aC. Stafford Glens Falls 11. `'.
Undertaker (Name) (Address)
the to hold temporari i the body.
(Undejtaker or ers aving charge of cow e) nt ove, or wi dispose of [state howl)
Dated arc � , 19 01 (Signed)
...... .... ... .
Local Registrar
This Permit is sufficient for the Removal (and Interment or Cremation) of a body to any part of the State (subject to local cemetery
or other regulations), unless removal is by common carrier, in which case a Transit Permit (VS No. 62) is required.
RS
�►L7'L+ Q.-.� zasE•y• 0 to' 0 a)"y ^W N^•t o L Y^ L ^Y-W , (q-. aa W 0 IA ^ L�`�•.co Vs Y.a)+ N W N. y V a N W s LC Lp
N
"�
b,
ig I
p.n 0 o • 0 ) 0o. 0 a. .;.0 0 v o 0. � °Y� c ° Cd a-a O N °•.J ~6�•
filO�Zi L NC > .Zj 6. ^= Yo v .�, Ev4.Y � o E0SW " vo0N oL w•^ a° v ev , ,: T0app3pv _sL waEp EpCou3 .. Lv3 >- 2V
Ov.� d
t.G aa '. Cd- oo v.O ; N.C _ = oa+„ vv ^ O0. v.�. Ev E Lf- • v.Y. a >. v� I-. i ° LuUv Yw ° Y
>- b. " L'na6 v s � ^ tiv vOsv ., a) a a ^•0 Y Y os
Y ° NNY ' y = toLC•° '" ° � 4.040 E0.aas L cY - a' uv a' Ecava,0eW 3 3y aiLy -W 'G C8 °s
a ° � ° NLL yY3N 0,aN t >
GO, .
yW a ouuo aoa3 v.0 .C4.. Q � OL. No suo ^ vC.7zD4
v.0 coso _ra : Y•AO= Na7 ^ voN `3 LWO.a
g04 CW � 3 O. E OwlY vs >' Y C � ° "vY bp s v us Y•o °c Y v.. Cy v L.= ou)•a, po
I- •...`,, a C �-0 0.0 3 L C. Y c 0.0 LY C:
.+� CA 'Y COa OLsL^ O .0 O o v
°OG ... + >,L•a ... c •.. v, , C. a. L s•o cid v � vLas vw CsiC 0a LI Q �iw•.>Q ►a ° •It ^ ° � oN . ,3 yLboc� Lh� ya'a...""00EoY., =IS v..C �.as
V° ocyco > e' a � aLas; � a•
aF t/1 s-- O aws LCy aaY C , E b0.. • v• .- w 0 o tV ° O LYN LO Nv >,� .y ma+Qt
' A zadA VNv L a oo - � � v vO lL E 5v 3aoaay o � b.d
z ~ . a.� a >,oL1-o `° � x v v • a 0 Y• v5 N 0 Co Qpa3ES". cco d i- ua °w o= N�N a.C � 0 Y t v.-p $1 Cw:E• acv ' a0. h'
"ZU` . yM E-+�•U0v� a 0- v.L .L '' v uL cow. aLaDa to'- 0Y . ' o ' p > cO .'O3w a
.C -... � aNsa � % � v � ° t' ° ; � v
^ ; � oLv baN Yci ==> •eZWW .o � C.3 . cca .� v'^ v u os o, � �u � m � mYa . - « ,- d '
02n r ww E•. > � Nc. '" YL" _ ^ aK 0as •� .0 a, Ep._=. . rcs t a , ,Ouwy
Q° Y " ,, O u ME- , NN p O >p > "Y Yt v io0 3Y vLaa v�^ � tICY �oCG oosN * ° Lc a- " Lo vv ., s oaw a a ,, � udxH.° o cdYYYaUY a Nb v f ^ v^ «. L•` � v..E•� .asY E b .ac'Y1 7 s pvL Wo:co .Dp^ oa> ^Dl11 !O0. s .. LvaW E-1 c caF v L.aaC u uy co N.- 's L_ a v s u
a Z W ° 2cov4. 0-° '" p, . ^ .0 yY L O.� v MCv L
9 m 4 C Z R... OQ-0a 3.C3 "' L >:w L >, N•o^•ev0vo 3i5v :'. 0- ° Naa� v: o8 s'-' .. p" 4,xu• . > vvLos vcw � NL
a. pa � 0 v a � ot dO aa� " vo- co . � oLa UL E > /lOV ; ., . v � v• N$uv s v
- M 0 ^ � � y�•N .. * . p Lw•.. O v d3 vyc ° Ewmv3N ° aN �
C') ar. aa ., 00 ..'� uv'' vE yE• v r °• ° xs' ` & c o0Y � C y L.- Cte� a)a0� waf G4,Z�Z t122oYa >;o� 0LL v._ v._« LN � 6tzuI0 ..z .orov.+Wos u a p.N >• C•- � `•� w ,£i. C
O x O a 6 a. os E''(y▪ W0>.•3 L 0y > N : y' > L. v s•�'aa= p, o .GO �bv W° Lo a1d.dyae�� ovda o QOIIIW• °.Uo. a3ao E Nn 4 asY
E..,+ 11 LIaa)1-4 �,X 6 a _ � > p • L�u = ° aa
.4hc
.Up oE0 » 00apEv21L aCwww OY .aC tY N ° C70Y
-�HCL1 0_m ' N'0 „T,• , > ' a• 0 : aF" 0c' v=1 _• , dN a 0. a C 2 ° 0.. 0d^ A Oo , ,a C , E �� , ^ EA viaowN .0 �W" « vY �
OW Z z w > V 'C y" ap wa v u NE 7 Lv •cs* ccf= 0 tioe >,vu.0 E o m ° No an•..•^ 0•. .0 0 v di •o..6. I
_wyw-1t. � °z .'-3vv Q u ov* Eo , ._ v a+.ccaeo'aodoys0a3 -o.av °. .. ug
Eyc/ yow . y oo0 ba ° � ^ L* ° . o • w s '
��•L °a >,`d � `° vv a0V. LNmos � .- p,
.-� aw � V � > L��• ao•aw OLUo ti0a* vO • o « O C• N
z� uE•O a) V/ O cI....N C Y•N RS U z L � .. 3cN U .0 y a" W Y C� N•^ o)v lib•N C N U'0 Y E � v.....6 es a L
CO
qv , MY LL L. ovv�w N u v0.= Qn 1Cb W W QMX xa 0 0 > _ N .„ � 1• = 4-. d E^ a wo0.. : ' r ,_ v4 31,3
2t,
•°0 > a 0 v 0 v0.0 .2 0' .OW - 0 4-, ets V cd (/� N2u es- '" � C 7 "2 p .F. NC • OG � •� _ c•- p• N .v v a tw�W
• . � .°+,, v ~ , YI- 4.0t cvo . O .0 oL0 .
•
•
W cw & 0.G t•, U... a aA W.0 u v y.^.0 L - v0 " ° O a CO.c v U = C L 'Ybo) CI Y am ° Nca LOq ,.. sYW�A� Wao•� A O ° 7ua'L ioG wx v C 7 Uv � N >,s.aAO .• �, aq 4.., C °V) " oW Ito N O O v o a . 0.of n�.� F p 0 i.. x..C4 .0.a O p u ; = EC N0. AyU . r > C ? is. aO 0 ON v▪ L "'' ' ' L N Y .0.0 O '"' >,C pa wyOY aa C--Y = Y0.400. Y , • Y.�p6) •\.... wi'0..• L N >,FOAOc0 •amY1 O'.0O xN« f0 a000,.LVJ aY.16
A W 2>4 C•U T 0 0 L'"H L., Em Y a > ynWa 'D^� 0 YON > as o>,L O Lb.0 L..= N N 4-
. O L.•p..+ L M = a E � N �� Y'Z(
�f
F a
Gy '0.° i C E4 Y Q " M-0-o L E v wv °_ a a Y ° N O M ° U a • c �M� asv N p' N A
Y ° 'C N •. v us'>_.a v.. O C O v o RS LW N LC al a ZO1» co,VVa .0 ca FY• 3 OE ^Y••E.. - O �• co,40a•- OO P.=Lt• � f6•- >1�cq Y.0a LNU0L.0 U0N^Cq 0.Y ^Q
md U V4 ' narU a 'C G• ....' °
nt .0... ...rI
ill
r ,•w o)W a L... L... p.�3aY Y � •..0 vO"GOa0 •..wNO >w30Lra.. aNaa CU0.aaaY.tU.a.a•Y.F �O0,N�7^3•.O OLCa>1YLOLvri�Yb•OYy OL.G3.5)� ZYY aoa
,..